Your Arthroscopic Shoulder Surgery, A Helpful Guide
Albert G. Volk, MD, FAAOS One Orthopaedic Place St. Augustine, Florida 32086
904.825.0540 Ext. 221 Fax 904.825.0517
ABOUT THE SURGEON
DR. VOLK attended college at The Johns Hopkins University and received his Medical De- gree from Indiana University School of Medicine. He completed his internship and residency program with the University of Southern California Orthopedic Department in Los Angeles, California. While at USC he had the opportunity to learn from and operate with shoulder sur- geon Dr. Frank Jobe at the esteemed Kerlan-Jobe Clinic in Centinela Hospital in Los Angeles, California. Following his residency, Dr. Volk completed a sports medicine shoulder and knee arthroscopy fellowship at the Matthews Orthopedic Clinic, Orlando Regional Medical Center in Orlando, Florida. There Dr. Volk received an additional one year of intensive training in shoulder and knee arthroscopy. He treated professional athletes including professional football, baseball, and basketball players for various sports injuries. Following his one year fellowship, Dr. Volk entered into private practice in St. Augus- tine where he currently resides and practices. He has extensive experience in treating conditions of the shoulder, mostly through arthroscopic procedures. He currently is the Chief Medical Advisor for the Professional Women’s Tennis Associa- tion and continues to evaluate and treat professional players with sports related injuries. He has two board certifications with the American Board of Orthopaedic Surgeons, one in Orthopaedic Surgery and the other in Sports Medicine. WELCOME
Thank you for choosing to have your arthroscopic shoul- en the recovery process. Most surgeries are performed der surgery with Albert G. Volk, MD at Orthopaedic As- on an outpatient surgery basis through three or four tiny sociates of St. Augustine. Our Team of experienced and VÃÃÊV>i`Ê>ÀÌ ÀÃV«VÊ«ÀÌÊ iðÊÊ/ ÃÊÃ}wV>ÌÞÊ compassionate professionals is dedicated to helping you lessens postoperative pain and facilitates postoperative achieve an improved level of activity and a higher quality rehabilitation with minimal scarring. of life. At Orthopaedic Associates, Dr. Volk has designed a post- Each year over 250,000 people in the United States un- «iÀ>ÌÛiÊ Ài >LÌ>ÌÊ «À}À>Ê Ì >ÌÊ ÃÊ Ã«iVwV>ÞÊ Ì>- dergo shoulder surgery. Candidates for the surgery in- lored to the type of shoulder surgery that you have un- clude those individuals with acute shoulder pain or injury `iÀ}i°Ê Ê 7 iÊ Ì iÀiÊ ÃÊ >Ê Ài«>ÀÊ vÊ >Ê ÀÌ>ÌÀÊ VÕvvÊ ÀÊ >Ê that has severely diminished their ability to perform nor- labrum, this usually entails wearing a postoperative sling mal daily activities without pain. Shoulder surgery can for a period of four to six weeks. The amount of time make a big difference in your ability to return to work, that you will need to recover is highly dependent on the sports, or other activities that you enjoy. procedure you had and on your preoperative physical conditioning. Most arthroscopic shoulder surgery patients recover quickly. New minimally invasive arthroscopic techniques The better your physical condition prior to surgery, the and improved instrumentation have allowed us to quick- quicker and more successful your recovery will be.
MISSION STATEMENT
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THE INTENDED PURPOSE OF THIS GUIDE
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DECISION FOR SURGERY
You and Dr. Volk have decided that the best treatment for your shoulder problem is shoulder arthroscopy.
Depending on the exact procedure and extent of the surgery will dictate:
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2 Your Arthroscopic Shoulder Surgery WHAT IS A SHOULDER ARTHROSCOPY
Arthro means joint and scope means to view inside that joint. An arthroscope is a small >ÀÀÜÊÌÕLiÊÌ >ÌÊÃÊÃiÀÌi`ÊÌÊÌ iÊà Õ`iÀÊÌÊÌ ÀÕ} Ê>Ê«iVÃâi`Ê iÊÌ ÀÕ} Ê Impingement 1 Ü V Ê>ÊwLiÀÊ«ÌVÊV>iÀ>]Ê} ÌÊÃÕÀVi]Ê>`ÊÜ>ÌiÀÊyÜÊ>ÀiÊ«>ÃÃi`°ÊÊ/ iÊV>iÀ>ÊÃÊV- iVÌi`ÊÌÊ>ÊL}ÊÃVÀii]Ê } `iwÌÊÌiiÛÃÊÌÀ°ÊÊ À°Ê6ÊÜÊLiÊ>LiÊÌÊÛiÜÊ the inside of your shoulder joint and identify frayed, torn, or degenerative tissue.
One or more small incisions are made in the joint for insertion of special instruments used to: Torn Labrum 2 UÊ iLÀ`iÊÌ iÊ`i}iiÀ>ÌÛiÊÌÃÃÕiÊÃÊÞÊ i>Ì ÞÊÌÃÃÕiÊ remains.
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New and improved shoulder arthroscopic inventions have led to quicker recovery times, less pain, and faster rehabilitation.
REASONS FOR SHOULDER ARTHROSCOPY
The reasons for shoulder arthroscopy might include: Torn Rotator Cuff 3 UÊRotator cuff tear - This is the tendon structure of the shoulder that is responsible vÀÊvÌ}ÊÞÕÀÊ>ÀÊÛiÀÊÞÕÀÊ i>`°Ê}ÕÀiÊή
UÊAdhesive capsulitisÊÊvÀâiÊÃ Õ`iÀ°
UÊBicipital tendonitis - frayed or inflamed biceps tendon.
UÊCalcific tendonitis - calcium deposits in the rotator cuff tendon.
UÊHistory of dislocations or subluxation of the shoulder - shoulder instability.
U Labral tears - This is a structure in the shoulder that helps to keep the shoulder in place. The labrum can become frayed, torn, or detached and may need debridement ÀÊÀi«>À°Ê}ÕÀiÊÓ® Arthritis and Loose Bodies 4 U Acromioclavicular joint arthritis - The joint between the collar bone and the acro- ÊLiViÃÊv>i`ÊÀÊ>ÀÌ ÀÌV°Ê}ÕÀiÊ{®
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A Helpful Guide 3 HOW TO PREPARE FOR ARTHROSCOPIC SHOULDER SURGERY
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THE WEEK OF SURGERY
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4 Your Arthroscopic Shoulder Surgery YOUR PREOPERATIVE VISIT WITH US
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WHAT KIND OF ANESTHESIA WILL I HAVE
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THE INTERSCALENE BLOCK
The anesthesiologist will clean your neck area with surgical preparation soap. Next they will insert a small thin needle into the side of your neck. A small amount of electricity is used to locate the proper nerve to your shoulder. Once the appropriate nerve is found, the anesthesiologist will inject a local anesthetic into this area. Other medications may be >``i`ÊÌÊVÀi>ÃiÊÌ iÊi}Ì ÊvÊÌiÊÌ >ÌÊÌ iÊLVÊÜÊ>ÃÌ°ÊÊ7 iÊÌ iÊLVÊÃÊV«iÌi`]ÊÞÕÊÜÊLiÊÌÀ>ÃviÀÀi`ÊÌÊ the operating room and put into a light sleep for surgery.
A Helpful Guide 5 PREPARE YOUR HOUSE BEFORE SURGERY
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THE DAY OF YOUR SURGERY
UÊ/ iÊ`>ÞÊ >ÃÊw>ÞÊ>ÀÀÛi`ÊvÀÊÞÕÀÊÃÕÀ}iÀÞ°ÊÊ/ iÊÃÌ>vvÊÃÊ } ÞÊÌÀ>i`ÊvÀÊ your procedure and for your comfort and safety. Remember, do not eat or drink anything after midnight.
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UÊ,iÛiÊ>Ê«iÀV}Ã°Ê iÌ>ÊL`ÞÊ«iÀV}ÃÊV>ÊV>ÕÃiÊLÕÀÃÊvÊivÌÊ°
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UÊ,iÛiÊ>Ê`iÌÕÀiÃÊÀÊ«>ÀÌ>ðÊÊ
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UÊ9ÕÀÊ6ÊÜÊLiÊÃÌ>ÀÌi`Ê>`ÊÜÊLiÊÕÃi`ÊÌÊÌÀ>ëÀÌÊyÕ`ÊÌÊÞÕÀÊÛiðÊÊ/ iÃiÊyÕ`ÃÊÜÊLiÊÕÃi`ÊvÀÊÀi>Ý>Ì]ÊÌÊ«ÕÌÊ you to sleep, to wake you up, to give you pain medications, and to give you antibiotics.
UÊvÌiÀÊÌ iÊ6Ê >ÃÊLiiÊÃÌ>ÀÌi`ÊÌ iÊ>iÃÌ iÃ}ÃÌÊÜÊ>`ÃÌiÀÊÞÕÀÊà Õ`iÀÊLV°ÊÊ9ÕÀÊLVÊà Õ`ÊÜÀÊvÀÊ£ÓÊ ÌÊÓäÊ ÕÀðÊÊ-iiÊÃiVÌÊÊÌiÀÃV>iiÊLV®Ê
6 Your Arthroscopic Shoulder Surgery PAIN CONTROL AFTER SURGERY UÊ9ÕÀÊà Õ`iÀÊLVÊà Õ`Êii«ÊÞÕÊVvÀÌ>LiÊvÀÊ£ÓÊÌÊÓäÊ ÕÀÃÊ>vÌiÀÊÃÕÀ}iÀÞ°ÊÊ9ÕÊ>ÞÊÌViÊ>ÊviÜÊÌ }ÃÊ>vÌiÀÊ surgery such as:
o The inability to move your shoulder and hand. o Swelling may feel different.
o Your hand and shoulder will be numb. o Your eyelid may droop.
o Your voice may be hoarse.
UÊ/ iÃiÊÃÞ«ÌÃÊ>ÀiÊÀ>Ê>`Êà Õ`ÊÜi>À vvÊÊÌ iÊiÝÌÊ£ÓÊÌÊÓäÊ ÕÀðÊ9ÕÊ>ÞÊviiÊiÊÞÕÊV>ÌÊÌ>iÊ>Ê`ii«Ê LÀi>Ì ]ÊÌ ÃÊÃÊ>ÊVÊVVÕÀÀiVi°ÊÜiÛiÀ]ÊvÊÞÕÊ >ÛiÊà ÀÌiÃÃÊvÊLÀi>Ì ÊÌ >ÌÊi>`ÃÊÌÊÃ}wV>ÌÊ>LÀi`ÊÀÊ`v- wVÕÌÞÊÊLÀi>Ì }]ÊÌ iÊÞÕÊà Õ`ÊV>ÊÌ iÊ« ÞÃV>ÊÊV>°ÊÊvÊÌ iÊLÀi>Ì }ÊÃÊiÝÌÀiiÞÊ`vwVÕÌ]ÊÞÕÊà Õ`ÊV>Ê ££ÊÀÊ«ÀVii`ÊÌÊÌ iÊi>ÀiÃÌÊiiÀ}iVÞÊÀ°ÊÊ
UÊ7iÊÀiVi`ÊÌ >ÌÊÞÕÊÀiÃÌÊ>vÌiÀÊÃÕÀ}iÀÞ°ÊÊvÊÞÕÀÊLVÊÃÌ>ÀÌÃÊÌÊÜi>ÀÊvvÊ>ÌÊÓÊ>°°]ÊÌ iÊÞÕÊ >ÛiÊ>Ài>`ÞÊ >`Êi} ÌÊ hours of sleep.
UÊ7 iÊÌ iÊLVÊÃÌ>ÀÌÃÊÌÊÜi>ÀÊvvÊ>`ÊÞÕÊ>ÀiÊLi}}ÊÌÊviiÊ>ÊÌÌiÊÕVvÀÌ>Li]ÊÞÕÊ>ÞÊLi}ÊÌÊÌ>iÊÞÕÀÊ pain medication that has been prescribed for your surgery. Do not wait for your block to completely wear off because Ì iÊ«>ÊVÌÀÊV>ÊLiÊÀiÊ`vwVÕÌ°
AFTER SURGERY
UÊ9ÕÊÜÊÜ>iÊÕ«ÊÊÌ iÊÀiVÛiÀÞÊÀÊÜÌ ÊÞÕÀÊ`ÀiÃÃ}Ê>`Êà Õ`iÀÊL- âiÀÊÊ«>Vi°ÊÊ*i>ÃiÊi>ÛiÊÌ iÊ`ÀiÃÃ}Ê>`Êà Õ`iÀÊLâiÀÊÊÕÌÊÞÕÀÊ wÀÃÌÊÀÌ «>i`VÊÀi >LÌ>ÌÊiiÌ}ÊÕÃÕ>ÞÊÊiÊÌÊÌ ÀiiÊ`>Þî°ÊÊ
UÊ9ÕÀÊwÀÃÌÊvwViÊ>««ÌiÌÊÜÊLiÊ>««ÀÝ>ÌiÞÊ£ÓÊ`>ÞÃÊvÜ}ÊÞÕÀÊÃÕÀ}iÀÞ°ÊÊ At that time we will take out your sutures, explain your surgery and show you the operative pictures. Your exact procedure and restrictions will be given to you.
ORTHOPAEDIC REHABILITATION
UÊ9ÕÀÊwÀÃÌÊÀÌ «>i`VÊÀi >LÌ>ÌÊÃiÃÃÊÜÊLiÊiÊÌÊÌ ÀiiÊ`>ÞÃÊ>vÌiÀÊÞÕÀÊ surgery.
UÊ ivÀiÊÃÕÀ}iÀÞÊ>iÊÃÕÀiÊÌ >ÌÊÞÕÀÊÃÕÀ>ViÊV«>ÞÊÀÊ7ÀiÀÃ½Ê «iÃ>- tion carrier approves the payment for your rehabilitation at the facility where you will be having it.
UÊ9ÕÀÊiÝ>VÌÊiÝiÀVÃiÃÊ>`ÊÀiÃÌÀVÌÃÊÜÊLiÊ>VVÀ`}ÊÌÊÌ iÊëiVwVÊÃÕÀ}iÀÞÊÌ >ÌÊÞÕÊ >`Ê«iÀvÀi`°
WHAT TYPE OF ORTHOPAEDIC REHABILITATION WILL I NEED?
Shoulder Arthroscopy Without Repair
If you have had any of the following surgeries without any type of repair:
UÊ iLÀ`iiÌÊvÊ>Ê«>ÀÌ>ÊÀÌ>ÌÀÊVÕvvÊÌi>ÀÊÊV>VwVÊÌi`ÌÃ]Ê>LÀÕÊ or biceps tendon.
UÊ ÕvÀ`ÊÊ«ÀVi`ÕÀiÊÊÀiÃiVÌÊvÊÌ iÊ`ÃÌ>ÊV>ÛVi°
UÊ-ÕL>VÀ>Ê`iV«ÀiÃÃÊÊ}Û}ÊÞÕÊÀiÊë>ViÊLiÌÜiiÊÌ iÊ top of the humeral head and the undersurface of the acromion.
UÊ-ÞÛiVÌÞÊÀÊLÕÀÃiVÌÞÊÊÀiÛ}Êy>i`ÊÌÃÃÕiÊvÀÊÃ`iÊ the shoulder.
A Helpful Guide 7 1 First six ÀÊ>ÞÊÌ iÃiÊ«ÀVi`ÕÀiÃ]ÊÞÕÊÜÊÕÃiÊÞÕÀÊà Õ`iÀÊLâiÀÊvÀÊVvÀÌÊ and can discontinue it whenever you feel comfortable. This is typically any- weeks where from seven to ten days after the surgery.
Early pendulum exercises and passive range of motion will be performed `ÕÀ}ÊÌ iÊwÀÃÌÊÜii°ÊÊ/ ÃÊÜÊiÛiÌÕ>ÞÊ«À}ÀiÃÃÊÌÊ>VÌÛiÊÀ>}iÊvÊÌÊ and active strengthening exercises when comfortable, which usually takes two to three weeks from the date of your surgery.
Arthroscopic Rotator Cuff Repair
If an arthroscopic rotator cuff repair was performed then your postoperative activity and restrictions will be as follows:
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UÊ Ì ÊÃÝÊ>`ÊÌ iÀi>vÌiÀÊÞÕÊ>ÞÊÀiÃÕiÊvÕÊÕÀiÃÌÀVÌi`Ê>VÌÛÌÞÊvÊÌ ÃÊÃÊ a primary repair and is less than 5 cm in diameter. If it is a revision repair or >ÃÊ>Ê`>iÌiÀÊvÊ}Ài>ÌiÀÊÌ >ÊxÊV]ÊÜiÊÜÊ >ÛiÊÞÕÊÜ>ÌÊÕÌÊ£ÓÊÌ ÃÊ postoperative to resume full unrestricted activity, which could include golf or overhead sports.
Arthroscopic Biceps Tenodesis 4 Week 13 & Thereafter If this is performed without a repair of the rotator cuff, then the same proto- VÊvÀÊÌ iÊ-*ÊiÃÊÀi«>ÀÊÃÊvÜi`ÊÃiiÊ-*ÊiÃÊÀi«>ÀÊ«ÀÌV®°Ê If this is performed with a rotator cuff repair, then the same protocol is used vÀÊ>ÊÀÌ>ÌÀÊVÕvvÊÀi«>ÀÊÃiiÊÀÌ>ÌÀÊVÕvvÊÀi«>ÀÊ«ÀÌV®°
Arthroscopic Repair of Subscapularis Tendon
vÊÜiÊÀi«>ÀÊÌ ÃÊëiVwVÊ«>ÀÌÊvÊÞÕÀÊÀÌ>ÌÀÊVÕvvÊÊÌ iÊvÀÌÊvÊÞÕÀÊà Õ`iÀÊ called the subscapularis muscle, certain exceptions to the rotator cuff proto- VÊÜÊ>««Þ°Ê/ ÃÊVÕ`iÃÊiÝÌiÀ>ÊÀÌ>ÌÊÀiÃÌÀVÌi`ÊÌÊäcÊvÀÊÌ iÊwÀÃÌÊÃÝÊ weeks and then increased as tolerated.
8 Your Arthroscopic Shoulder Surgery Arthroscopic Anterior Instability Repair
If we perform surgery to correct a dislocating shoulder, the following restrictions and activities apply:
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U / iÀ> >`ÁÊÃÌÀi}Ì i}ÊÃÊLi}ÕÊ>ÌÊÃÝÊÌÊi} ÌÊÜiið
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Arthroscopic Superior Labrum Anterior-Posterior (SLAP) Repair
vÊÞÕÊ >`Ê>ÊÀi«>ÀÊvÊ>Ê-*ÊiÃ]ÊÌ iÊvÜ}Ê>VÌÛÌiÃÊ>`ÊÀiÃÌÀVÌÃÊÜÊ>««Þ\
U ÀÊÌ iÊwÀÃÌÊvÕÀÊÜiiÃ]ÊÞÕÊÜÊLiÊÀiµÕÀi`ÊÌÊÜi>ÀÊÌ iÊÃ}Ê>ÌÊ>ÊÌið
U ÕÀ}ÊÌ ÃiÊvÕÀÊÜiiÃ]ÊÞÕÊÜÊLiÊÕÀ}i`ÊÌÊ«iÀvÀÊiÝÌiÀ>ÊÀÌ>ÌÊÃÌÀiÌV iÃÊ>ÃÊv>ÀÊ>ÃÊ«ÃÃLiÆÊÜÌ ÊÞÕÀÊ}>Ê being to try and match the external rotation of the side that was not operated on by the end of four weeks.
U vÌiÀÊvÕÀÊÜiiÃÊÌ iÊÃ}ÊÜÊLiÊ`ÃVÌÕi`°ÊÊÌÊÌ ÃÊ«Ì]ÊÞÕÊV>ÊLi}ÊÛiÀ i>`ÊÃÌÀiÌV }Ê>`ÊVÌÕiÊÜÌ Ê passive external rotation stretches.
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U vÊÞÕÊiÝ«iÀiViÊ«>ÊÜÌ ÊÀiÃÃÌi`ÊvÀÜ>À`ÊyiÝÊvÊÌ iÊ>ÀÊ>ÌÊÃÝÊÜiiÃÊ«ÃÌ«iÀ>ÌÛiÞ]ÊÜiÊÜÊ`i>ÞÊLVi«ÃÊVÕÀÃÊ until eight weeks postoperatively.
U ÌÊÌ ÀiiÊÌ ÃÊ«ÃÌ«iÀ>ÌÛiÞÊÞÕÊV>ÊLi}ÊÜÀ}ÊÕÌÊÜÌ ÊÃÌÀi}Ì i}ÊÊÌ iÊ}Þ°ÊÊ >ÃiL>Ê«>ÞiÀÃÊV>ÊLi}Ê ÌÊLÊ>ÊL>ÃiL>Ê>`ÊÌ>ÌiÊÃiÊÃÜÊÌ ÀÜ}ÊÌðÊÊ7iÊÜÊÕÃÕ>ÞÊ}iÌÊÞÕÊÊ>ÊÌiÀÛ>ÊÌ ÀÜ}Ê«À}À>Ê beginning four months postoperatively.
U ÌÊ ÃiÛiÊ Ì ÃÊ «ÃÌ«iÀ>ÌÛiÞÊ ÞÕÊ V>Ê Li}Ê ÌÊ ÀiÌÕÀÊ ÌÊ vÕÊ >`Ê ÕÀiÃÌÀVÌi`Ê >VÌÛÌÞ]Ê VÕ`}Ê >Ê ÛiÀ i>`Ê sports.
SOME POSTOPERATIVE EXCEPTIONS
Calcific Tendonitis
*>ÌiÌÃÊÜ Ê >ÛiÊ>ÀÌ ÀÃV«VÊÃÕÀ}iÀÞÊÌÊÀiÛiÊV>VÕÊ`i«ÃÌÃÊÊÌ iÊÀÌ>ÌÀÊVÕvvÊÌi`ÊÌÊLiViÊÀiÊy>i`Ê and stiff after surgery. Therefore we start immediate postoperative stretching, including passive elevation with a rope and pulley and passive external and internal rotation.
SLAP Lesion Repair in Association with Small Rotator Cuff Tear
7iÊ >ÛiÊvÕ`ÊÌ >ÌÊÊ}iiÀ>]Ê«i«iÊÜ Ê >ÛiÊÌ iÃiÊÌÜÊ«ÀVi`ÕÀiÃÊÌi`ÊÌÊ`iÛi«ÊÀiÊ«ÃÌ«iÀ>ÌÛiÊÃÌvviÃÃÊ and therefore we now start immediate passive forward elevation as well as passive internal and external rotation.
A Helpful Guide 9 POSSIBLE COMPLICATIONS
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REASONS TO CALL THE DOCTOR
UÊ vwVÕÌÞÊLÀi>Ì }°
UÊ iÛi«Ê>ÊÌi«iÀ>ÌÕÀiÊ}Ài>ÌiÀÊÌ >ʣ䣰xc°
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SUMMARY
This preoperative brochure is meant to:
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GOALS
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o Your sport.
o Your activities of daily living.
o The quality of life you deserve.
THANK YOU
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10 YAthiShldSYour Arthroscopic Shoulder Surgery FREQUENTLY ASKED QUESTIONS
HOW SUCCESSFUL IS THE SURGERY? If a repair is performed, expect:
Ê }iiÀ>]Ê >ÀÌ ÀÃV«VÊ ÃÕÀ}iÀÞÊ vÊ Ì iÊ Ã Õ`iÀÊ ÃÊ nxÊ UÊ-ÌÌ}Ê`iÃÊLÊqÊÓÊÌÊÎÊÜiià -95% successful, depending on the complexity of the op- UÊ"ÊÞÕÊviiÌÊLÊqÊÎÊÌÊÈÊÜiià eration and adherence to the postoperative rehabilitation UÊ} Ê`i>`ÊLÊqÊÓÊÌÊ{ÊÌ ÃÊ «ÀÌV°Ê*ÀÊÕÌViÃÊ >ÛiÊLiiÊ>ÃÃV>Ìi`ÊÜÌ \Ê WHEN CAN I DRIVE? U *ÀÊÌÃÃÕiʵÕ>ÌÞ° U >À}iÊÀÊ>ÃÃÛiÊÌi>ÀÃ°Ê }>]Ê Ì ÃÊ `i«i`ÃÊ Ê >Ê Ài«>ÀÊ ÛiÀÃÕÃÊ Ê Ài«>À°Ê 7Ì Ê U *ÀÊV«>ViÊÜÌ Ê«ÃÌ«iÀ>ÌÛiÊÀi >LÌ>ÌÊ>`Ê ÊÀi«>À]ÊÞÕÊÜÊLiÊ>LiÊÌÊ`ÀÛiÊÊ£ÓÊÜiiðÊ7Ì Ê>Ê restriction. Ài«>À]ÊÞÕÊV>ÊiÝ«iVÌÊÌÊÀiÌÕÀÊÌÊ`ÀÛ}ÊvÀÊÓÈÊÜiiÃÊ U *>ÌiÌÊ>}iÊ`iÀÊÌ >ÊÈxÊÞi>Àî°Ê following your surgery. This will depend on the extent of the repair and the frequency and distance you need to WHAT ARE THE COMPLICATIONS AND FREQUENCY? `ÀÛi]Ê>ÃÊÜiÊ>ÃÊÞÕÀÊVw`iViÊiÛi°
Fortunately, complications from shoulder surgery are in- HOW LONG DO I HAVE TO WEAR THE SLING? frequent, and those from arthroscopic surgery are even iÃÃÊ V°Ê / iÃiÊ VÕ`iÊ ÜÌ Ê vÀiµÕiVÞÊ vÊ VVÕÀ- 7Ì ÕÌÊ>ÞÊÌÞ«iÊvÊÀi«>ÀÊÞÕÊV>Ê`ÃVÌÕiÊÌ iÊÃ}Ê ÀiVi®\Ê as soon as you are comfortable without it. This can be >ÞÜ iÀiÊ vÀÊ xÊ `>ÞÃÊ ÌÊ ÓÊ ÜiiÃ°Ê Ê 7Ì Ê >Ê Ài«>À]Ê ÜiÊ £°Ê iÀÛiÊÕÀÞʣʫiÀViÌ®\Ê/ ÃÊÀ>ÀiÞÊVVÕÀÃÊvÀÊÀi«>ÀÊ }iiÀ>ÞÊ >ÛiÊÞÕÊÜi>ÀÊÌ iÊÃ}Ê>ÊvÊÌ iÊÌiÊiÝVi«ÌÊ of massive rotator cuff tears, where soft-tissue releases à ÜiÀ}®ÊvÀÊÌ iÊwÀÃÌÊÎÊÜiiðÊ/ iÊvÀÊÜiiÊÎÊÈÊÞÕÊ are necessary and there is a potential for stretching the only need to wear the sling if you are up walking around nerves. the house or you go outside of the house. Those with massive rotator cuff repairs need to wear the sling up to Ó°ÊviVÌÊiÃÃÊÌ >ʣʫiÀViÌ®\Ê1ÃiÊvÊ>ÌLÌVÃÊ`ÕÀ}Ê nÊÜiiÃÊ>vÌiÀÊÃÕÀ}iÀÞ° the procedure and sterile surgical technique limit the risk of infection. DO I HAVE TO WEAR THE SLING AT NIGHT?
ΰÊ-ÌvviÃÃÊiÃÃÊÌ >ʣʫiÀViÌ®\Ê >ÀÞÊÀi >LÌ>ÌÊ«À- 7Ì ÕÌÊ>ÞÊÀi«>À]ÊÞÕÊ`ÊÌÊii`ÊÌÊÜi>ÀÊÌ iÊÃ}Ê>ÌÊ tocols decrease the likelihood of permanent stiffness or } Ì°Ê7Ì Ê>ÊÀi«>À]ÊÜiÊÜ>ÌÊÞÕÊÌÊÜi>ÀÊÌ iÊÃ}ÊÜÌ Ê loss of motion following a rotator cuff repair. This also less Ì iÊ«ÜÊvÀÊÌ iÊwÀÃÌÊÎÊÜiiÃÊ>vÌiÀÊÃÕÀ}iÀÞ°ÊvÌiÀÊÌ >Ì]Ê frequent with arthroscopic procedures. ̽ÃÊÕ«ÊÌÊÞÕ°Ê-iÊ«i«iÊw`ÊÌÊÀiÊVvÀÌ>LiÊÌÊ Üi>ÀÊÌ iÊÃ}Ê>ÌÊ} ÌÊLiÞ`ÊÌ iÊÎÊÜiiÃ]ÊiëiV>ÞÊvÊ {°Ê/i`ÊÀiÌi>ÀÊÈÊ«iÀViÌ®\Ê-iÛiÀ>ÊÃÌÕ`iÃÊ >ÛiÊ`VÕ- Ì iÞÊ>ÀiÊÀiÃÌiÃÃÊÃii«iÀðÊÃ]ÊvÀÊÌ iÊwÀÃÌÊÃiÛiÀ>Ê} ÌÃÊ mented tearing of the rotator cuff following all types of >vÌiÀÊÌ iÊÃÕÀ}iÀÞ]ÊÃiÊ«i«iÊw`ÊÌÊÀiÊVvÀÌ>LiÊ repairs. It appears that tendon re-tear does not guaran- to sleep in an upright position or in a recliner chair. tee a poor result, return of pain, or poor function. WHERE CAN I GET MORE INFORMATION? WHEN CAN I SHOWER? *i>ÃiÊviiÊvÀiiÊÌÊV>Ê>`Ê>ÃʵÕiÃÌÃÊ>ÌÊ>ÞÊÌi°Ê9ÕÊ iiÀ>ÞÊÃÌÊ«i«iÊ>ÀiÊ>LiÊÌÊà ÜiÀÊÓÎÊ`>ÞÃÊ>vÌiÀÊ V>Êw`ÊÀiÊvÀ>ÌÊÊiÊ>Ì\ÊÊÜÜÜ°>ÃÌ>Õ}°V Ì iÊÃÕÀ}iÀÞ°Ê/ ÃÊÃÊÕÃÕ>ÞÊ>vÌiÀÊÌ iÊwÀÃÌÊ`ÀiÃÃ}ÊV >}iÊ or www.orthoinfo.aaos.org. >ÌÊ ÀÌ «>i`VÊ Ài >LÌ>Ì°Ê 7iÊ >ÃÊ ÞÕÊ ÌÊ ii«Ê Ì iÊ incisions dry with waterproof adhesive bandages and or plastic wrap and tape. Also, it is important that you do ÌÊÃÕLiÀ}iÊÌ iÊVÃÃÊÊÜ>ÌiÀÊÌÕLÊÀÊ«®ÊÕÌÊ>ÌÊ i>ÃÌÊ{nÊ ÕÀÃÊ>vÌiÀÊÌ iÊÃÕÌÕÀiÃÊ>ÀiÊÌ>iÊÕÌÊÓÊÜiiÃÊ >vÌiÀÊÃÕÀ}iÀÞ®°
WHEN CAN I GO BACK TO WORK?
This of course depends on what type of work you do and what type of surgery you have. In general, for arthroscop- ic surgery without any type of repair:
UÊ-ÌÌ}Ê`iÃÊLÊqÊ£ÊÌÊÓÊÜiià UÊ"ÊÞÕÀÊviiÌÊLÊqÊÓÊÌÊ{ÊÜiià UÊ} Ê`i>`ÊLÊÀiµÕÀ}ÊÛiÀ i>`Ê>VÌÛÌÞÊqÊÈÊÌÊnÊ weeks (L-R) Albert Volk, MD; Patrick Thompson, PA-C, MPAS; Arlow Bailey, OPA-C
AAH Helpfull f l GuideG id 11 IT TAKES A JOINT TASK FORCE TO PROVIDE QUALITY POST-OP CARE
Count on on Welcome Welcome Homecare’s Homecare’s award-winning award-winning staff to continue staff tothe expert continuecare you require the expert to recuperate care you at home.require Our to programsrecuperate help at preventhome. Ourinfections, programs helpenhance prevent healing, infection, and restore enhance maximum healing, mobility and – allrestore in the maximum comfort of mobilityyour home. – all in the comfort of your home. Welcome Homecare’s Advantages: JACKSONVILLE .... 904-727-9624 JACKSONVILLELIC# HHA21285096 ...... 904-727-9624FAX: 904-720-0059 U Compassionate nurses certified in advanced wound-care, LIC# HHA21285096 ...... FAX: 904-720-0059 diabetic cardiac protocols and medication management ORANGE PARK .... 904-272-5044 LIC# HHA21789096 ...... FAX: 904-269-2485 U Supervision by your orthopedic surgeon ORANGE PARK .... 904-272-5044 LIC# HHA21789096 ...... FAX: 904-269-2485 U One-to-one care by licensed Physical Therapists ST. AUGUSTINE.... 904-461-0461 LIC# HHA299991624 ...... FAX: 904-461-0468 U Seamless integration between surgical team and ST. AUGUSTINE.... 904-461-0461 Welcome Homecare LIC#FER HHA299991624NANDINA...... 904-277-8330FAX: 904-461-0468 LIC# HHA21790096 ...... FAX: 904-277-7923 U Advanced technologies used in healing, tracking FERNANDINA ...... 904-277-8330 and communications LIC#MACCLENNY HHA21790096 ...... 904-259-3111FAX: 904-277-7923 LIC# HHA217880961 ...... FAX: 904-259-5176 MACCLENNY ...... 904-259-3111 PALM COAST ...... 866-461-0461 LIC# HHA217880961 ...... FAX: 904-259-5176 LIC# HHA299991624 ...... FAX: 866-461-0468 PALM COAST ...... 866-461-0461 LIC# HHA299991624 ...... FAX: 866-461-0468
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